Early combination therapy of COVID-19 in high-risk patients.

Publication date: Nov 29, 2023

Prolonged shedding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been observed in immunocompromised hosts. Early monotherapy with direct-acting antivirals or monoclonal antibodies, as recommended by the international guidelines, does not prevent this with certainty. Dual therapies may therefore have a synergistic effect. This retrospective, multicentre study compared treatment strategies for corona virus disease-19 (COVID-19) with combinations of nirmatrelvir/ritonavir, remdesivir, molnupiravir, and/ or mABs during the Omicron surge. Co-primary endpoints were prolonged viral shedding (≥ 10 copies/ml at day 21 after treatment initiation) and days with SARS-CoV-2 viral load ≥ 10 copies/ml. Therapeutic strategies and risk groups were compared using odds ratios and Fisher’s tests or Kaplan-Meier analysis and long-rank tests. Multivariable regression analysis was performed. 144 patients were included with a median duration of SARS-CoV-2 viral load ≥ 10 copies/ml of 8. 0 days (IQR 6. 0-15. 3). Underlying haematological malignancies (HM) (p = 0. 03) and treatment initiation later than five days after diagnosis (p 

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Concepts Keywords
Coronavirus COVID-19
Haematological Dual anti-SARS-CoV-2 therapies
Load10 Immunocompromised host
Severe Individualized therapeutic approaches
Therapy Prolonged viral shedding


Type Source Name
disease MESH COVID-19
disease VO Severe acute respiratory syndrome coronavirus 2
disease MESH immunocompromised hosts
disease MESH virus disease
drug DRUGBANK Ritonavir
disease MESH viral shedding
disease MESH malignancies
disease MESH Infection
disease VO organization
disease IDO immunodeficiency
disease VO vaccination
disease MESH Infectious Diseases
disease MESH tuberculosis
pathway KEGG Tuberculosis
disease VO effective
drug DRUGBANK Pentaerythritol tetranitrate
disease VO effectiveness
disease VO dose
disease VO time
drug DRUGBANK Coenzyme M
disease IDO history
disease VO organ
disease MESH HIV infection
pathway REACTOME HIV Infection
disease VO immunization
disease VO vaccinated
drug DRUGBANK Spinosad
disease VO ANOVA
disease VO population
disease IDO immunosuppression

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